A recent study conducted by UCL researchers has found a concerning 65% rise in the number of children and young people being admitted to general acute medical wards in hospitals in England due to mental health concerns over the past decade, from 2012 to 2022. This significant increase highlights the growing challenge of addressing mental health issues in children and young people, revealing gaps in existing health care systems.
The research, published in The Lancet Child and Adolescent Health journal, examined data from the National Institute for Health and Care Research (NIHR) and NIHR Great Ormond Street Hospital Biomedical Research Centre (NIHR GOSH BRC), covering admissions of five- to 18-year-olds across medical wards in England over a 10-year period.
General acute medical wards, separate from specialized mental health wards, are designed for rapid assessment and care, serving as a critical transition between emergency departments and specialized treatments. Children are often admitted to these wards because they are too unwell to return home or require urgent medical attention. The study revealed that between 2012 and 2022, mental health-related admissions surged from 24,198 to 39,925, a striking 65% increase. In comparison, all-cause admissions rose by just 10.1%, from 311,067 to 342,511.
The most notable increase was seen among girls aged 11-15, whose admissions nearly doubled, rising by 112.8%, from 9,091 to 19,349. There was also a substantial rise in admissions for eating disorders, which increased by 514.6%, from 478 to 2,938 cases.
Dr. Lee Hudson, Senior Author and researcher at the UCL Great Ormond Street Institute of Child Health, emphasized that while there has been growing recognition of the need for better mental health services, particularly in community and inpatient settings, admissions to general acute medical wards have been largely overlooked. These wards play an important role in managing children with mental health conditions, particularly those with physical health complications, such as those suffering from eating disorders.
Dr. Hudson noted the significant challenges these rising numbers pose for medical staff and hospital infrastructure. Acute medical wards, typically not designed for mental health care, are struggling to meet the growing demand for support. Additionally, staff may lack the specialized training needed to address the complex needs of young patients with mental health concerns. This situation calls for improved collaboration between physical and mental health professionals, better training, and enhanced integration of support services across hospitals and communities.
The study also found that these increases in mental health admissions cannot solely be attributed to the COVID-19 pandemic, as admissions have been rising steadily since 2012. This suggests that the growing mental health crisis among young people is a long-standing issue that requires urgent attention and long-term planning.
While the study could not pinpoint the exact reasons behind the increase in admissions, researchers are continuing to gather more detailed data from children’s wards and interviews with patients, their families, and medical staff. They hope this will shed light on the root causes of these rising admissions and inform the development of more effective interventions and care strategies.
A recent report from the Health Services Safety Investigations Body (HSSIB) highlighted multiple concerns regarding the care of children and young people with mental health issues in general acute wards. These included inadequate resources for therapeutic engagement, challenges in managing high-risk behaviors, and difficulties with the physical environment of the wards. The HSSIB survey found that 13 out of 18 pediatric units reported their wards were “not safe” for patients with mental health problems.
Researchers stress the need for better integration between acute, mental health, and social care services to provide comprehensive support for young patients. They hope their findings will help guide improvements in care delivery, ensuring that children and young people receive the support they need both in hospital and in the community.
The study’s limitations include potential underreporting of mental health admissions due to variations in diagnostic coding and the inability to distinguish between pediatric and adult wards. The study also could not account for changes in admission criteria during the pandemic.
Ongoing research in the MAPS project, which is collecting more detailed data on hospital admissions and interviewing young patients and their families, aims to address these gaps and provide a clearer picture of the challenges facing mental health care for children in England.
The researchers’ ultimate goal is to inform policy and improve the quality of care for young people experiencing mental health crises, helping to ensure that they receive timely, appropriate, and effective support in both hospital and community settings.
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